Executive Summary

Governor Judy Martz and Attorney General Mike McGrath jointly formed the Alcohol, Tobacco and Other Drug Control Policy Task Force (Task Force) to address the drug and substance abuse issues facing Montana. The goal of the Task Force was to collaboratively develop statewide drug control strategy recommendations. AQuest ~ Collaborative Solutions, of Corvallis, Montana, was contracted to facilitate the process and prepare the final written document.

The Task Force's effort was funded primarily through a $62,505 U.S. Department of Justice grant called the Edward Byrne Memorial Block Grant. Task Force members brought a broad range of expertise to the task. The members met around the state seven times between February 2002 and August 2002 and worked independently or in smaller groups between meetings to develop the following report. Public input was solicited and incorporated throughout the process.

The Task Force assessed the current situation related to tobacco, alcohol and other drug control issues in Montana by looking at the broad areas of prevention, treatment and judicial. The Task Force then created Desired Outcomes for Montana. Based on this information, research and valuable public input, the Task Force developed strategy recommendations to help Montana reach those Desired Outcomes.

Simply said, we are not effectively preventing Montana's youth from engaging in harmful and illegal activities. Montana's youth have the 2nd highest rate of illicit drug use, 6th highest rate of tobacco use, and 4th highest rate of alcohol use of all 50 states. Montana's youth are using marijuana and sedatives at rates above the national average. The costs of not preventing substance abuse are high in terms of both human lives and monetarily. Montanans spent approximately $256 million in 1998 on programs related to the negative effects of substance abuse. Less than 1% of that was invested in prevention and treatment.

The Task Force identified and explored seven areas that function as barriers or challenges to providing effective tobacco, alcohol and other drug prevention measures in Montana. The barriers include:

Lack of leadership's support.

Our culture and the mixed messages we send.

Lack of comprehensive education and information availability and motivational tools.

Fragmented services.

Insufficient and unstable funding.

Lack of commitment to science-based prevention programs and uniformity.

Insufficient workforce development.

The Task Force reviewed national studies which document the effectiveness of substance abuse treatment programs in both helping patients and reducing societal costs. In fact, a study of California alcohol and drug treatment services found that every dollar invested in treatment generates a savings of $7.14 in future costs for taxpayers.

To understand the complexities and importance of the treatment system it is important to understand the science and nature of addiction. Drug addiction is a "brain disease". Every drug user starts out as an occasional voluntary user. But as time passes and drug use continues, a person goes from being a voluntary to a compulsive drug user because, over time, use of addictive drugs changes the structure and function of the brain.

For prevention and treatment to be effective the unique needs of different populations must be addressed. When treatment is done well, recognizing the varied needs of individuals, the likelihood of success increases significantly. The Task Force looked at issues and the current situation related to treatment for seven special populations: adults, Native Americans, youth, corrections populations, pregnant women and women with children, methamphetamine addicts, and patients with co-occurring addiction and mental disorders. The Task Force identified and explored six areas that function as barriers or challenges to providing effective tobacco, alcohol and other drug treatment measures in Montana. The barriers include:

Lack of access to treatment.

Attitudes and stigma.

Funding and treatment costs.

Lack of education and engagement.

Lack of specific care levels.

Workforce challenges.

Montana's total prison incarceration rate jumped 198% between 1983 and 1998. A 1997 study showed that 89% of all inmates in the Montana State Prison and Montana Women's Prison had a lifetime substance abuse disorder and records in Yellowstone County, as an example, show dramatic increases in drug offenses between 2000 and 2001. Without effective treatment addicted criminal offenders will likely return to the system over and over again. Supporting this premise are probation and parole officers' reports of an increase in revocations especially among alcohol and methamphetamine substance abusers. Over 50% of offenders entering the prison system are parole and probation revocations.

Methamphetamine is putting increased demands on public funds and resources. Violent crimes increased by 37 percent in Montana between 1999 and 2000 with aggravated assaults showing the largest increase. Law enforcement officers attribute the increase, in large part, to violence committed under the influence of meth. The number of meth labs is increasing significantly throughout Montana, impacting local law enforcement, property values and communities.

Montana has only 18 of the 39 key laws that are important deterrents to driving under the influence of drugs or alcohol, according to Mother's against Drunk Driving. In 1999, 47 percent of all Montana youth auto fatalities (15 -20 year olds) were alcohol related. This is higher than the national rate of 31 percent. The National Highway Traffic Safety Administration estimates that alcohol-related crashes in Montana cost the public $600 million in 1998 and the average alcohol-related fatality cost $3.3 million.

Jurisdictional challenges exist with coordinating a statewide drug control policy with the seven Indian reservations in Montana. A number of factors are involved to determine which government has jurisdiction of crimes committed on reservations. Development and implementation of a drug control policy must be mindful of tribal, state and federal laws.

The Task Force concluded that instead of "getting tough on crime" related to alcohol, tobacco and other drug issues in Montana, we need to "be effective on crime" which means Montana also needs to be effective in prevention and effective in treatment. Based on their assessment of the current situation the Task Force has recommended a comprehensive blueprint of policy and strategy changes that they agree are necessary to reduce the significant social and financial impacts of substance abuse that currently plague Montana.

A Strategy Recommendation Table appears in Appendix B of this document. This six page table can be used as an Executive Summary of the Desired Outcomes and Strategy Recommendations from the Alcohol, Tobacco and Other Drug Control Task Force. Thirteen Desired Outcomes were identified with a corresponding sixty seven specific recommendations the Task Force agrees are necessary to help Montana reach those Desired Outcomes.

Foremost among the recommendations is the call for a high level Drug Czar position with the responsibility, authority and resources to integrate the currently divergent alcohol, tobacco and other drug control (ATOD) programs. The Task Force feels this position is critical for very practical reasons. The person in this position will be the champion and driving force for moving Montana toward its desired outcomes in a comprehensive and effective manner. This position is viewed as essential to managing effective and integrated prevention, treatment, public health and judicial programs in Montana. Research has shown that investment in effective prevention and treatment programs now will save substantially in societal costs later. Other "Czars" have been created in Montana, but perhaps none with such potential for savings for the taxpayers as this position.

The entire process to develop this "Blueprint for the Future" was one of consensus building and prioritization. What remains in this document is agreed by the diverse interests on the Task Force to be a priority. It is a comprehensive package because a comprehensive approach is needed to move us from where we are to where we want to be. A comprehensive approach is necessary for us to be effective in preventing our youth from engaging in harmful and illegal substance abuse; effective in treating Montanans who have the chronic illness of addiction; and effective in reducing alcohol and drug related crime.

This "Blueprint for the Future" is an essential starting point; it can not be the end. This "Living Document" should change and evolve as more information is gained and as Montana's needs evolve. It is a solid plan, nevertheless, with which to start to build our new future. The Task Force believes we must start to implement this plan now in order to effectively reduce ATOD related deaths, injuries, crimes and societal costs in Montana.